H.R. 3164: Ensuring Community Access to Pharmacist Services Act

The Ensuring Community Access to Pharmacist Services Act (H.R. 3164) is a bipartisan bill introduced on May 1, 2025, by Representative Adrian Smith (R-NE) and co-sponsored by 98 other members of Congress. The bill aims to amend Title XVIII of the Social Security Act to allow Medicare to reimburse pharmacists for providing certain healthcare services that are currently reimbursed only when provided by physicians. Specifically, it would enable pharmacists to offer testing and treatment for COVID-19, influenza, respiratory syncytial virus (RSV), and strep throat, as well as services needed during federally declared public health emergencies. Under this legislation, Medicare would reimburse pharmacists at 85% of the physician fee schedule for these services, with full reimbursement during public health emergencies. The bill seeks to improve healthcare access, especially in underserved areas, by leveraging pharmacists' capabilities to provide timely care for common illnesses.

The Ensuring Community Access to Pharmacist Services Act has received strong support from various healthcare organizations. The Academy of Managed Care Pharmacy (AMCP) applauded the bill, emphasizing that it would improve health equity and combat public health threats by allowing pharmacists to provide essential services, particularly in vulnerable communities. Similarly, the Society of Emergency Medicine Pharmacists (SEMP) endorsed the legislation, highlighting its potential to close Medicare coverage gaps for pharmacist-provided test-to-treat services and alleviate overcrowded emergency departments. These endorsements suggest that the bill is viewed positively for its potential to enhance healthcare accessibility and efficiency.

While specific negative media coverage of H.R. 3164 is limited, potential concerns may arise regarding the financial implications for Medicare and the healthcare system. Critics might argue that expanding Medicare reimbursement to pharmacists could increase overall healthcare spending. Additionally, there could be apprehension about the quality of care if pharmacists take on roles traditionally performed by physicians, especially in complex cases. Some physician groups might express concerns over scope-of-practice issues, fearing that this expansion could encroach upon their professional domain. These perspectives suggest that, despite the bill's intentions to improve access, there may be debates over its economic impact and the appropriate roles of healthcare providers.

The Ensuring Community Access to Pharmacist Services Act, sponsored by Adrian Smith, presents significant potential conflicts of interest due to the substantial financial backing from the health professionals sector. With $200 million in donations from health professionals, who are directly affected by the legislation, there is a clear financial incentive for the sponsor to promote policies that may benefit this industry. This overlap raises concerns about whether the interests of the sponsor's donors are influencing legislative priorities over the needs of constituents. Additionally, the lack of transparency in lobbying activities related to this bill further complicates the situation, as undisclosed amounts from various entities could suggest hidden agendas that may not align with public interest.

These industries are both affected by this bill and among the sponsor's top donors.

Organizations that lobbied on issues related to this bill's policy area.

Source: Senate Lobbying Disclosure Act (LDA) filings, 2026

Top industries funding Adrian Smith, ranked by total contributions.

Source: OpenSecrets.org (Center for Responsive Politics)